Kornimate/medical-research-clean huggingface dataset:
assessing the benefit of pipelle biopsy in patients with postmenopausal bleeding and an atrophic-appearing cavity

Conditions: Postmenopausal Bleeding; Endometrial Cancer; Endometrial Hyperplasia

Summary: postmenopausal bleeding (pmb) is the occurrence of vaginal bleeding 12 months following a woman's last menstrual cycle. pmb represents one of the most common reasons for referral to gynaecology services. approximately 10% of women with pmb will be found to have endometrial cancer. the gold standard of investigation of pmb is ambulatory gynaecology through the outpatient hysteroscopy clinic, which is often combined with pipelle biopsy for endometrial sampling. up to 60% of women that present with pmb will have an atrophic-appearing cavity at hysteroscopy. this provides a challenge in obtaining a histological sample through both dilatation \& curretage (d\&c) and pipelle biopsy. often, scant tissue that is insufficient for clinical diagnosis is obtained. pipelle biopsy is associated with patient discomfort. it is also associated with costs related to the purchasing of equipment and the processing of samples in the laboratory to the sum of approximately 30 euro per sample. it is rare that a sample taken from an atrophic cavity will return any clinically meaningful result. a negative hysteroscopy reduces the probability of endometrial cancer to 0.6%. this study aims to compare patients with pmb and atrophic-appearing cavity that undergo pipelle biopsy to those that do not. differences in pain scores, cost saving and differences in clinical follow up will be assessed to evaluate the benefit of pipelle biopsy in patients with pmb and atrophic-appearing cavity.


Eligibility criteria:
inclusion criteria: * postmenopausal * postmenopausal bleeding * tolerates hysteroscopy exclusion criteria: * premenopausal * any lesion requiring biopsy at time of hysteroscopy * obvious cause of bleeding from the vagina or cervix at time of hysteroscopy * history of endometrial hyperplasia/cancer

Keywords: postmenopausal bleeding ambulatory gynaecology endometrial sampling endometrial hyperplasia endometrial cancer
the impact of two-field or three-field lymphadenectomy on overall survival in middle and lower thoracic esophageal squamous cell carcinoma: an observational study

Conditions: Esophageal Cancer

Summary: to clarify the effect of two-field or three-field lymphadenectomy on the survival of esophageal squamous cell carcinoma.


Eligibility criteria:
inclusion criteria: * 1. men and women aged 18-85 years * 2. histologically confirmed primary thoracic esophageal squamous cell carcinoma, * 3. staging pt1b-4a, n0-3, m0 ajcc eighth edition * 4. excluding lymph node dissection \< 15, (meeting the guideline criteria) * 5. the tumor located in the lower middle thoracic. exclusion criteria: * 1. patients with a history of previous thoracic and abdominal surgery that may affect lymphatic reflux * 2. patients with distant metastasis confirmed by imaging * 3. patients with obvious surgical contraindications.
cognitive rehabilitation of executive dysfunction - goal management training in patients with acquired brain injury

Conditions: Brain Injuries

Summary: the main objective of this study is to examine the effect of goal management training for patients with executive difficulties after acquired brain injury in a randomized controlled trial. the effect on cognitive functioning will be examined, as will the relationship between treatment effects and lesion location and size. the effect of goal management training on regulating emotions, quality of life and coping will be examined. the generalizability of treatment effects across etiologies will be explored by comparing effects in three patient groups; traumatic brain injury, cerebrovascular accidents and resected brain tumors. structural magnetic resonance imaging (mri) scans and measures of white matter connectivity will be used to establish detailed lesion descriptions. functional mri data will provide information on the neural underpinnings of treatment related change. a secondary objective is to expand the goal management training protocol with increased focus on emotional regulation and adherence to homework assignment.


Eligibility criteria:
inclusion criteria: * traumatic brain injury, stroke and resected brain tumor patients with no concomitant diseases * minimum 6 months post-injury/surgery * reporting executive problems by structured interview or baseline assessment (cognitive performance measures) exclusion criteria: * major psychiatric disorder or reported ongoing alcohol or substance abuse * premorbid neurological disease or insult and/or comorbid neurological disease * aphasia or other specified language problems causing potential communication problems * impaired basic cognitive, linguistic, mnemonic, motor, or perceptual function that can interfere with the ability to engage with the training
bone marrow micrometastases in patients with early stage breast cancer

Conditions: Breast Cancer

Summary: operable early stage breast cancer patients staged according to nccn guidelines are subjected to bone marrow aspiration/trephine biopsy at the time of the definitive operation under general anesthesia. the specimen will be fixated in neutral tamponaded formalin and the sections will be examined by h\&e and cytokeratin immunohistochemically. if disseminated tumor cells are identified er (estrogen receptor), pr (progesterone receptor), her2/neu will be studied. disseminated tumor cells will be recorded quantitively and semiquantitatively. results of the pilot study will be evaluated as observational study.


Eligibility criteria:
inclusion criteria: 1. patients over 18 years old and who have given informed consent to enter the study. 2. asa i-ii patients 3. patients who have not been diagnosed as breast cancer or received any type of treatment regarding breast cancer before the time of study 4. patients who are appropriate for bone marrow biopsy 5. menopausal status is not relevant. exclusion criteria: 1. active collagen tissue disorders 2. patients who are diagnosed having breast cancer and received any type of treatment regarding breast cancer before the time of study 3. pregnancy 4. patients with bleeding disorders, who are receiving antiaggregant or anticoagulant medication. 5. patients who refused to enter the study protocol and refused to give informed consent.
cohort of patients with a symptomatic rotator cuff tear treated without surgical repair

Conditions: Rotator Cuff Tear

Summary: in accordance with national guidelines surgical repair of rotator cuff tear is the first-line strategy only in young patients, depending on tear size, fatty infiltration of rotator cuff muscles and articular status. in appropriate situations, a satisfactory result is expected in more than 80% of cases with a very good long-term outcome. on the other hand, the first-line strategy in older patients is conservative as the main objective is the treatment of pain and stiffness of the shoulder which can be achieved at least in the short-term with general and local medications and physiotherapy. in addition, poor prognostic factors such as massive tears and muscle fatty infiltration or atrophy, are more frequently present in those patients, leading to poor results of surgical treatment and a high risk of iterative tear after repair. because of a lack of evaluation, there is currently no identified prognostic factor of medical treatment and on the other hand no clinical situation in which a surgical repair is mandatory. therefore, investigator designed this study as an observatory with the follow up of patients with a symptomatic rotator cuff tear treated conservatively.

patients are regularly monitored in rheumatology consultation at 3 months, 6 months, 1 year, 2 years, 30 months, 3 years, 42 months, 4 years, 54 months and 5 years supplemented by simple radiological monitoring and an mri followed by 1 year, 2 years and 5 years.

Eligibility criteria:
inclusion criteria: * having a clinical symptoms suggesting a rotator cuff tear. * having a full-thickness tear of the rotator cuff confirmed by mri. * covered by the social security system. exclusion criteria: * being included in another clinical trial with a potential alteration of shoulder pathology management. * having a partial tear of the rotator cuff. * having a single lesion of the bicipital tendon. * having a traumatic tear of the rotator cuff less than 3-month old. * having surgery for rotator cuff tear planned within 3 months. * unable to understand the study protocol. * having a contra-indication to mri.

Keywords: rotator cuff tear mri
skin/soft tissue elasticity in head and neck cancer survivors with lymphedema and fibrosis

Conditions: Lymphedema

Summary: this research trial studies skin/soft tissue elasticity in head and neck cancer survivors with lymphedema and fibrosis. lymphedema and fibrosis is a common effect of head and neck cancer which may lead to skin tightness, pain, and body image issues. early detection of lymphedema and fibrosis may help reduce serious functional loss of the neck. shear wave elastography is a technique that provides a quantitative measure of stiffness using a push pulse to generate shear waves within the tissues. conventional imaging techniques are then used to monitor the shear waves generated through the tissue to calculate the shear wave speed. shear wave elastography may help obtain an early and accurate measurement of tissue elasticity in head and neck cancer survivors.

primary objectives: i. to obtain pilot data of the elasticity of skin/soft tissues using shear wave elasticity at the defined anatomical sites in head and neck cancer survivors with lymphedema and fibrosis (lef). ii. to explore the correlation between elasticity of skin/soft tissues and the following: 1) symptoms as measured by the lymphedema symptom intensity and distress survey-head and neck (lsids-hn); 2) functional impact as measured by cervical range of motion device and the vanderbilt head and neck symptom survey; and 3) physical exam findings as measured by head and neck lef grading criteria. outline: participants will be evaluated for lef status using the head and neck external lymphedema - fibrosis (hn-lef) grading criteria and neck range of motion using the cervical range of motion device. participants also complete study questionnaires, including vanderbilt head and neck symptom survey (vhnss) and lymphedema symptom intensity and distress survey - head and neck (lsids-h\&n). participants undergo ultrasound shear wave elastography over 20-25 minutes. participants' cancer disease and treatment information will be gathered from their medical records.

Eligibility criteria:
inclusion criteria: * histologically confirmed cancer involving the head and neck * completed all therapy * no evidence of cancer (ned) * ability to understand english in order to complete questionnaires * able to provide informed consent exclusion criteria: * have medical record documentation of significant cognitive impairment that would preclude the ability to provide informed consent * are unwilling to undergo the study assessment * have recurrent and/or metastatic cancer

Keywords: head and neck cancer lymphedema and fibrosis
perfetti method in upper extremity of stroke patients

Conditions: Stroke

Summary: the cognitive sensory motor training therapy (perfetti's technique) might be more effectiveness than conventional occupational therapy on upper extremity function recovery after acute stroke patients.

globally, stroke is the second leading cause of death above the age of 60 years, and the fifth leading cause of death in people aged 15 to 59 years old. upper extremities problem is still faced with poor prognosis for recovery. cognitive sensory motor training therapy (perfetti's technique) might be better helped for recovery of upper extremity function in stroke than conventional therapy.

Eligibility criteria:
inclusion criteria: * first ever stroke * impaired upper extremity function * given signed inform consent exclusion criteria: * unstable medical condition * any upper extremity functional impairment prior to stroke * can not adequately cooperate in training * severe communication problems * severe cognitive - perceptual deficits * fixed contracture more than 30 degree in every upper extremity joint

Keywords: stroke upper extremity rehabilitation perfetti
identification of early cardiovascular disease risk factors in normal-weight obesity

Conditions: Metabolic Syndrome; Obesity

Summary: the purpose of this study is to identify early cardiovascular disease risk factors in those with "normal-weight obesity" (i.e., normal body, but high body fat percentage) that better track with their long-term cardiovascular disease risk.


Eligibility criteria:
inclusion criteria: control group: normal bmi, body fat percentage \< 25% for men and 35% for women normal-weight obesity group: normal bmi, body fat percentage \> 25% for men and 35% for women metabolic syndrome group: bmi \> 30 and 2 or more of the following: blood pressure \>130/85 mmhg, fasting glucose \>100 mg/dl, fasting triglycerides \>150 mg/dl, hdl cholesterol \< 40 mg/dl (men) or \< 50 mg/dl (women). exclusion criteria: * presence of pacemaker * pregnant * use of tobacco products * using lipid lowering drugs
a study in adults with type 2 diabetes

Conditions: Diabetes Mellitus, Type 2

Summary: the main purpose of this study is to compare the effectiveness and safety of ly2963016 versus lantus in controlling blood sugar levels in combination with two or more oral diabetes medications.


Eligibility criteria:
inclusion criteria: * have type 2 diabetes mellitus based on the disease diagnostic criteria world health organization (who) classification * have been taking at least 2 types of oral diabetes medications for at least 12 weeks prior to entering the study * have a hemoglobin a1c value greater than or equal to 7.0 percent and less than or equal to 11.0 percent if insulin naive if previously on lantus, then hemoglobin a1c must be less than or equal to 11.0 percent * have a body mass index of less than or equal to 45 kilogram per meter squared (kg/m\^2) exclusion criteria: * have significant liver, cardiac or gastrointestinal disease * have active cancer or have had cancer within the past 5 years (with the exception of basal cell carcinoma or carcinoma in situ) * have an excessive resistance to insulin or hypersensitivity to lantus * have had more than one episode of severe low blood sugar (defined as needing someone else to help because you had very low blood sugar) within the 6 months before entering the study * have taken any other insulin other than lantus within the past 30 days * taking any other diabetes medicines that are not allowed in the study or not approved to be taken with insulin

Keywords: diabetes type 2 diabetes
evaluation of immune status before and after splenectomy in immune thrombocytopenia patients

Conditions: Thrombocytopenia; Splenectomy

Summary: evaluation of immune status before and after splenectomy in immune thrombocytopenia patients.

a total of 30 itp patients will be enrolled in the study. these patients should fail to have sustained response to multiple first- and second-line treatments of itp and agree to have splenectomy. before splenectomy, these patients will be reassessed and still diagnosed with itp.their platelet level will be raised to a safe state before surgery, and the laparoscopic splenectomy will be performed in tianjin people's hospital. the investigators plan to take 20ml of peripheral blood (pb) of these patients at 6 time points, including 1 day before surgery, 1 week, 1 month, 3 months, 6 months, and 12 months after surgery, and take a small amount of spleen tissue during surgery. 18 age- and gender- matched healthy donor will also be enrolled as controls and taken 20ml of peripheral blood. the investigators also plan to take splenic tissue from 10 patients who have splenectomy due to hereditary spherocytosis or trauma. and then the investigators will do the experiments step by step. 1, isolation of peripheral blood and splenic mononuclear cells;2, detection of the percentage of cell population;3, activation and proliferation of b lymphocyte; 4, activation and proliferation of t lymphocyte;5,apoptosis of platelets by cytotoxic t cells;6,phagocytosis of platelets by macrophages in spleen;7,enzyme-linked immunosorbent assay (elisa) for cytokines.

Eligibility criteria:
inclusion criteria: * aged 18 to 60 years old, male or female; * conform to the diagnostic criteria of immune thrombocytopenia (itp) * needed splenectomy; * people who are willing to sign the informed consent voluntarily and follow the research program. exclusion criteria: * secondary thrombocytopenic purpura; * patients with poor compliance; * researchers believe that patients should not participate in the test of any other condition.

Keywords: thrombocytopenia splenectomy
evaluation of 2%bromelain gel with 0.2%chx gel as subgingival ldd following srp in stage ii/iii and grade b periodontitis -a rct

Conditions: Periodontal Pocket

Summary: the current study is a prospective randomised study evaluation of 2%bromelain gel with 0.2%chlorhexidine gel as subgingival local drug delivery following scaling and root planing in stage ii/iii and grade b periodontitis

36 sites with periodontal pocket depth measuring 4-6mm were selected. the sites selected were divided into 1. group i (control)- 12 sites with probing depth of ≥5mm treated with scaling and root planing alone. 2. group ii -12 sites with probing depth of ≥5mm treated with scaling and root planing followed by placement of bromelain gel. 3. group iii -12 sites with probing depth of ≥5mm treated with scaling and root planing followed by placement of chlorhexidine gel. periodontal pack was placed and patient was recalled at 1week,4th week and 12th week

Eligibility criteria:
inclusion criteria: * patient with have chronic periodontitis in the age group between 30-50 years. * patients having ≥20 teeth. -.patients with radiographic evidence of bone loss in atleast two teeth. * patients who are systematically healthy. * patients with localized pockets with probing depth of ≤ 5mm. * patients who are cooperative and able to attend the hospital for regular follow-up. exclusion criteria: * patients who have received any surgical or nonsurgical therapy during past 6months * pregnant or lactating females. * use of systemic antibiotics in the past 6 months. * patient who are not willing to give a written informed consent
anesthetic depth and the incidence of emergence agitation in children undergoing strabismus surgery

Conditions: Strabismus

Summary: this study evaluates the association between the depth of general anesthesia and the occurrence of emergence agitation (ea). the investigators hypothesized that optimal level of anesthetic depth could decrease the incidence of ea in children undergoing strabismus surgery compared to the deep level of anesthetic depth.

ea is characterized by dissociated state of consciousness, in which the children are inconsolable, irritable, uncooperative, thrashing, crying, moaning or incoherent. several predisposing factors for ea include post-operative pain, rapid emergence from general anesthesia, use of volatile anesthetics, type and site of operation (usually head \& neck surgeries), agitation on induction, airway obstruction, hyperthermia or hypothermia. the effect of anesthetic depth on the ea has rarely been evaluated in pediatric population, even though postoperative delirium or postoperative cognitive dysfunction (pocd)corresponds to the ea identically. in this study, the concentration of anesthetics was not managed on purpose to lower the bis score. patients were allocated to each group based on the result of average bis score during the operation.

Eligibility criteria:
inclusion criteria: * aged between 3 and 5 years * american society of anesthesiologists physical status i or ii exclusion criteria: * american society of anesthesiologists physical status over iii, * any disease that could affect mental status * pre-existing forehead wound

Keywords: anesthetic depth emergence agitation
using the non invasive technology magnetic resonance elastography for the diagnosis of liver fibrosis stage

Conditions: Liver Diseases

Summary: this study evaluates the ability of magnetic resonance elastography non invasive technology to identify the liver fibrosis stage in patients with chronic liver diseases compared to shear wave elastography and/or liver biopsy.

recent advances in magnetic resonance imaging (mri) of the liver have led to improvements in diagnosis of chronic liver diseases. detection and staging of liver fibrosis has become important; however, until about the last decade, it depended on an invasive liver biopsy. liver biopsy is limited by high cost, low patient acceptance, interobserver variability during microscopic evaluation, sampling error, poor reproducibility, and, importantly, an invasive nature with a complication rate of 3% and a mortality rate of 0.03%. with the emergence of elastography techniques, the need for liver biopsy has rapidly diminished for diagnosis of clinically significant liver fibrosis. magnetic resonance elastography has gained increasing popularity in recent years, in large part due to its higher technical success and ability to overcome some of the weaknesses of ultrasound-based methods for assessing liver fibrosis.

Eligibility criteria:
inclusion criteria: * patients with chronic liver diseases exclusion criteria: * patients who don't have chronic liver diseases
subarachnoid-subarachnoid (s-s) bypass versus adhesion lysis in spinal arachnoiditis and syringomyelia

Conditions: Syringomyelia

Summary: to determine whether subarachnoid-subarachnoid (s-s) bypass results in better patient outcomes with fewer complications and improved quality of life compared to intradural adhesion lysis in individuals with spinal arachnoiditis and syringomyelia.

participants with spinal arachnoiditis and syringomyelia will be randomized to either have a subarachnoid-subarachnoid (s-s) bypass or intradural adhesion lysis. the participant will then return to the neurosurgeon's office at the following time points which are consistent with standard of care practice: 3-6 months, 12 and 24 months. at these visits, the clinician will complete a physical exam and the participant will report on the prognosis of symptoms and complete questionnaires. a spine mri will be performed 3-6 months, 12 and 24 months after the decompression.

Eligibility criteria:
inclusion criteria: * 1) history of traumatic spinal cord injury or other infection; 2) evidence of progressive neurological deficit, and/or pain syndrome; 3) mri showing a syringomyelia due to spinal trauma or other infection; and 4) minimum follow-up period of more than 1 year. exclusion criteria: * chiari-malformation, myelomalacia, subarachnoid cyst, syringomyelia due to other spinal diseases (such as degenerative spinal disease)

Keywords: syringomyelia
telephone based management of hyperlipidemia

Conditions: Hyperlipidemia

Summary: the purpose of the study is to demonstrate that systematic self measurement of blood lipids reduces ldl cholesterol more effectively than standard care. the hypothesis is that cholesterol lowering medication adherence will be improved with self monitoring and reporting of frequent blood lipids and the percentage of patients achieving ldl goal will be greater than without home monitoring.

the study utilizes a telephone reporting system to self report lipid values and provide educational counseling regarding lifestyle modification methods to reduce cardiovascular risk. study patients will be randomized to receive a home monitoring device and will be instructed on its use. generic simvastatin will be given to reduce ldl levels in all groups. it is the hypothesis that those study patients receiving a home device will reach target ldl (goal ldl) more frequently than those randomized to usual care( no device).

Eligibility criteria:
inclusion criteria: * ldl \> 130mg/dl exclusion criteria: * pregnant patients * liver disease * allergic reaction to statins

Keywords: internet based monitoring system